Arch Hellen Med, 29(5), September-October 2012, 599-605
Self-assessment of depression in patients with diabetes mellitus and its correlation with complications
M. Rekleiti,1 Z. Roupa,2 I. Kyriazis,3 G. Wozniak,4 M. Saridi,5 P. Kyloydis,6 M. Kourakos,7 K. Souliotis8
OBJECTIVE The evaluation of depression in patients with types 1 and 2 diabetes mellitus (DM) and its correlation with features of the disease and the presence of complications.
METHOD Patients with DM were recruited from the diabetic outpatient departments of hospitals in the Attica region and Korinthos, 164 in total, 72 men and 92 women, with a mean of age 66.9±11.53 years. The tools that were used were the scale of self-assessment of depression of Zung (ZDRS) and a structured questionnaire covering demographic data, body measurements and information concerning the course of the disease. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) v. 18.0.
RESULTS Regarding the somatometric status, 57.3% of patients were overweight and 30.5% obese, with high rates of central obesity (83.3% in the men and 92.4% in the women). A high body mass index [r=0.309, p=0.001] and central obesity [t(162)=4.773, p=0.001] were significantly associated with depression as assessed by the ZDRS. Of the sample of patients with DM, 50% presented symptoms of depression at a low level and 20% at a medium level, with the female sex [t(162)=3.26, p=0.001] and age [r=0.492, p=0.001] being correlated to a statistically significant degree with depression. Severe depression was correlated with the duration of disease (mean 12.96±7.07 years [r=0.354, p=0.001]), the years of monitoring in the diabetic outpatient department (mean 9.08±5.64 years [r=0.221, p=0.005]) and poor regulation, as assessed by the concentration of HbA1c (28.8% [r=0.415, p=0.001]). The most frequent complications recorded were sexual impairment in the men (52.8%), which was strongly age-related [r=0.459, p=0.001], and retinopathy (40.2% [r=0.369, p=0.001]), neuropathy (34.8% [r=0.304, p=0.001]) and nephropathy (22% [r=0.344, p=0.001]), which were correlated with the duration of disease and depression.
CONCLUSIONS The majority of this sample of patients with DM presented a low or medium degree of depression, which was observed to be correlated with poor glycemic control. The presence of most chronic complications, and particularly neuropathy, was strongly associated with the appearance of symptoms of depression. Appropriate investigation, evaluation of difficulties and creation of a protective environment are very important for the resolution of problems associated with DM, the adaptation of the individual, the prevention of complications and achievement of optimal regulation of DM.
Key words: Complications, Depression, Diabetes mellitus.